Objective To evaluate the usefulness of arteriovenous fistula in an upper extremity constructed by using great saphenous vein autograft for blood access in hemodialysis. Methods A total of 12 patients with end stage renal disease were observed. Their fistulas were difficult to be constructed using the local vessels, but their great saphenous veins were patent on ultrasound examination. We connected brachial artery or radial artery to the great saphenous vein autograft, which then passed through the forearm subcutaneous tissue in straight or U profile, and end-to-side anastomosed to median cubital vein, cephalic veins or basilic vein. The inner diameters of anastomosis stomas and autografted vein were measured at different period. Blood flow in hemodialysis was recorded, and Kt/V was calculated. Results Operation for fistula construction was successful without any complication such as infection or hematoma. Thrombosis occurred in 2 patients after the operation for 2.5 months and 3 months, respectively. The inner diameter of the stoma was 0.48±0.06cm at the arterial end, and was 0.52±0.10cm at the venous end. Blood flow during hemodialysis was 270.8±32.0ml/min, and Kt/V was 1.65±0.19. The average expense of this surgical operation was 1807 yuan/patient. Conclusion Arteriovenous fistula in an upper extremity constructed by using autograft of great saphenous vein for blood access is associated with rare complications, higher patency rate for a long period of time, sufficient blood flow during hemodialysis, and less expense for the operation. This operation can be used in patients with inadequate vascular access.